1. What is single port gynecologic surgery?
In accessing the abdominal and pelvic cavity with a single incision (either in the skin of the abdomen in traditional abdominal access or in the mucosa of the bottom of the vagina in vaginal access).
2. Is it less invasive than other procedures?
Yes, they are minimally invasive surgical accesses. In the case of single-port laparoscopic vaginal access, we can save incisions in the abdominal wall and, therefore, prevent scarring at that level. he was the doctor Jan Baekelandt (Imelda Hospital, Bonheiden, Belgium) the first to develop it in 2014 with a single vNOTES-type port, although it was not until 2019 when it was disseminated worldwide.
3. What applications does it have in Gynecology and Obstetrics?
It allows us to directly access the female pelvis, easily approaching the adnexa (ovaries and fallopian tubes). can be resolved ovarian cysts, solid lesions smaller than 4 or 5 centimeters, tubal ligations, removal of ovaries and/or tubes, etc… Additionally, it allows access to the obturator fossa, a space located on the sides of the pelvis where the lymph nodes are located, which frequently drain malignant lesions from the genital tract, and thus be able to make an assessment of possible lymph node metastases. . Lastly, it represents an important support for exeresis of the uterus (hysterectomy) through the vagina in patients without prolapse of this organ.
4. What advantages does it have for patients?
It supposes a faster recovery, as there is less postoperative pain, shorter hospital stay (even in certain cases outpatient surgery can be considered, without hospital admission). It also prevents injuries at the skin level, with a aesthetic benefit clear and a very early incorporation into the family, social and work life of the patients.
5. You are a pioneer in the development of this technique in the Canary Islands and you have already performed two operations. What were these cases?
Well, a patient was a carrier of a genetic mutation that implies a greater risk of developing ovarian cancer and who, due to her age and associated pathologies, was proposed and decided to undergo a prophylactic bilateral adnexectomy. The second case involved a patient with a unilateral, solid, benign ovarian tumor measuring 5 centimeters, suggestive of ovarian fibromathecoma, who underwent unilateral adnexectomy, directly assessing and preserving the contralateral adnex.
6. What will the implementation mean for the female population of the islands?
It will mean a very clear improvement in the health of patients, insofar as it will allow the surgeon to perform certain surgical treatments with a small access point, with a very small incision, in an inconspicuous place, with little risk of bleeding and a limited postoperative pain. All this makes it possible to carry out selected surgeries on an outpatient basis, without hospital admission, so that patients recover quickly and completely very quickly, continuing with their normal life in less than a week.
7. Do you plan to extend its application to other ailments?
As the technique refines and, above all, the experience and confidence of the surgeon increase, the indications for this type of surgical approach will expand. The next step will be the systematic performance of surgeries through a single port assisted with a surgical robot.
8. What led you to bet on developing this single port surgery procedure?
The main objective of our work is the patients, their health and their well-being: the cure of a disease when possible or to improve the quality of life when the cure of the disease is far from our reach. For the surgeon, being able to carry out a surgical procedure generating the minimum anatomical damage is essential.
9. What are the origins of this innovation?
Procedures began to be developed in the 1980s. minimally invasive by introducing laparoscopic surgery, initially in benign pathologies and later for the treatment of oncological processes. This was a decisive advance, since it was possible to perform extensive, complex surgeries through 4 or 5 small incisions in the abdominal wall, replacing the large ones, which on many occasions generated unfavorable post-surgical complications for the patient (infections, bleeding, pain).
10. Did you need specific training to carry it out?
Whenever a new surgical technique is started, it is necessary to carry out training that allows us to have the greatest capacity and security to develop it safely. Previous surgical experience greatly facilitates learning and, from there, the accumulated subsequent experience will allow us to shorten the duration of the procedures, expand the indications and improve the technique itself. Having accepted the leadership of the Gynecology and Obstetrics Service at QuirónSalud Tenerife implies a commitment to the development of the most innovative surgical procedures available at the service of women in the Canary Islands in general and Tenerife in particular.
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